Young-age onset colorectal cancer in Brazil: Analysis of incidence, clinical features, and outcomes in a tertiary cancer center

Silva, Andrea C.B.; Vicentini, M; Mendoza, Elizabeth Zambrano; Fujiki, Fernanda Kaori; Fonseca, Leonardo Gomes da; Braghiroli, Maria Ignez; Hoff, Paulo M.

doi:10.1016/j.currproblcancer.2019.01.009

Cited by 19 publications

(23 citation statements)

References 35 publications

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“…Red flag signs or symptoms precede 70-95% of early-onset CRC cases. [43][44][45][46] Rectal bleeding is the most commonly reported red flag symptom in early-onset CRC cases, with abdominal pain, change in bowel habits (including constipation and diarrhea), unexplained weight loss, and anemia also frequently reported. 43,45,[47][48][49] Despite these common presentations, few studies have examined whether, on average, these red flag signs or symptoms are predictive of early-onset CRC.…”

Section: Early-onset Crc Red Flag Signs and Symptomsmentioning

confidence: 99%

“…[43][44][45][46] Rectal bleeding is the most commonly reported red flag symptom in early-onset CRC cases, with abdominal pain, change in bowel habits (including constipation and diarrhea), unexplained weight loss, and anemia also frequently reported. 43,45,[47][48][49] Despite these common presentations, few studies have examined whether, on average, these red flag signs or symptoms are predictive of early-onset CRC. A recent study comparing early-onset CRC cases to later-onset CRC cases and controls found abdominal pain, rectal pain, change in bowel habits, rectal bleeding, and weight loss were associated with increased early-onset CRC risk.…”

Section: Early-onset Crc Red Flag Signs and Symptomsmentioning

confidence: 99%

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An Update on the Epidemiology, Molecular Characterization, Diagnosis, and Screening Strategies for Early-Onset Colorectal Cancer

et al. 2021

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Rising trends in the incidence and mortality of early-onset CRC in those who are ages less than 50 years have been well-established. These trends have spurred intense investigation focused on elucidating the epidemiology and characteristics of early-onset CRC, as well on identifying strategies for early detection and prevention. In this review, we provide a contemporary update on early-onset CRC with a particular focus on epidemiology, molecular characterization, red flag signs and symptoms, and screening for early-onset CRC.

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Section: Early-onset Crc Red Flag Signs and Symptomsmentioning

confidence: 99%

Section: Early-onset Crc Red Flag Signs and Symptomsmentioning

confidence: 99%

An Update on the Epidemiology, Molecular Characterization, Diagnosis, and Screening Strategies for Early-Onset Colorectal Cancer

et al. 2021

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“…One study conducted among young Nigerians and African-American populations with CRC observed that 75% of the patients were diagnosed with rectal cancer[ 23 ]. Two retrospective studies from Singapore and Brazil found that young CRC patients tended to present with left-sided tumors[ 24 , 25 ]. The latest study, presented herein, revealed that early-onset CRC patients presenting left-sided tumors were slightly more prevalent than late-onset CRC patients, although this difference was not significant.…”

Section: Discussionmentioning

confidence: 99%

Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors

Makmun¹,

Simadibrata²,

Abdullah³

et al. 2021

WJCC

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BACKGROUND An increasing trend in colorectal cancer (CRC) occurring at younger ages has been observed worldwide, even though incidence is declining in the general population. Most currently available guidelines still recommend CRC screening for older populations, despite an alarming rise in early-onset CRC incidence. Risk stratification is necessary to further determine the population most at risk for early-onset CRC. However, epidemiological data on related clinical characteristics and potential risk factors, especially in developing countries, have not been widely reported. AIM To investigate the prevalence, demographics, clinicopathologic features, and associated factors of young-onset CRC patients in a tertiary hospital in Indonesia. METHODS Patients undergoing colonoscopy examination between 2008 and 2019, yielding a diagnosis of CRC were identified from medical records. The subjects were classified into two groups according to their age at diagnosis, namely early-onset (18-49 years old) and late-onset (≥ 50-years-old). Demographic data, characteristics, and risk factors of both onset age groups were evaluated using the chi-square and Fisher’s exact test. RESULTS Among 495 CRC patients confirmed by histopathology, 205 (41.4%) were classified as early-onset and 290 (58.6%) as late-onset. Most subjects in the early-onset CRC group were male (53.7%), with 89.8% displaying adenocarcinoma histopathology. A majority (78%) of the early-onset CRC patients had left-sided tumors, with the rectum (41%) and rectosigmoid (17.6%) being the most common sites. Abdominal pain was the most frequent symptom in the early-onset CRC patients (55.6%), which was significantly higher than that in the late-onset CRC patients (43.8%, P < 0.05). Early-onset CRC cases were more likely to be underweight (34.6% vs 20.0%, P < 0.001) compared to late-onset CRC cases. The proportion of subjects with suspected hereditary nonpolyposis colorectal cancer (HNPCC) was also higher in the early-onset CRC group than in the late-onset age group (9.3% vs 4.1%, P < 0.05). However, no difference was observed in the parental or family histories of CRC cases. CONCLUSION Early-onset CRC patients were more likely to have abdominal pain, underweight status, and HNPCC suspicion than late-onset CRC patients.

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“…With respect to CRC, Brazil had an incidence of 36,360 new cases of colorectal cancer being 17,380 and 18,980 cases among men and women, respectively, with an increasing incidence in those under 50 years of age (2). This increasing incidence is associated with a growing elderly population and increased mortality associated with CRC when combined with inactivity (3,4).…”

Section: Introductionmentioning

confidence: 99%

The Budget Impact of Monoclonal Antibodies Used to Treat Metastatic Colorectal Cancer in Minas Gerais, Brazil

Silva

Godman

Acúrcio

et al. 2021

Appl Health Econ Health Policy

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Introduction: Biological medicines have increased the cost of cancer treatment and has raised sustainability concerns. In Brazil, three monoclonal antibodies (MABs): bevacizumab (BEVA), cetuximab (CETUX) and panitumumab (PANIT), are indicated for the treatment of metastatic colorectal cancer (mCRC) but currently not currently funded by the Unified Health System (SUS). However, they have been funded following successful litigation cases. Objective: Evaluate the budget impact of BEVA, CETUX and PANIT MABs if they became part of standard chemotherapy to treat mCRC within the SUS of Minas Gerais (MG), in Brazil. Method: Budget impact analysis incorporating MABs as first-line treatment of mCRC in MG/Brazil was explored. The Brazilian health system -SUS perspective was adopted and a 5-year time horizon was applied. Data from the lawsuits from January 2009 to December 2016 were collected and the model was populated based national databases and published sources. Costs are expressed in USD. Results: 351 court lawsuits were granted for first-line MAB treatment for mCRC. In three alternative scenarios analyzed there was an increase in costs, which ranged from 348 to 395% compared to the reference scenario. PANIT presented a $103,360,980 budget impact compared to the reference scenario over a 5-year time horizon. BEVA and CETUX presented a $111,334,890 and $113,772,870 budget impact, respectively. Considering the restrictions on the use of MABs Anti EGFR (CETUX and PANIT) in patients with about 41% KRAS mutations, the best cost alternative adopted for incorporation should be the combination of the PANIT and BEVA antibodies, which demonstrated a cost of approximately $106 million. Conclusion: These results highlight the appreciable costs for incorporating BEVA, CETUX and PANIT into the SUS. It is likely appreciable discounts will be needed to permit incorporation.

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Young-age onset colorectal cancer in Brazil: Analysis of incidence, clinical features, and outcomes in a tertiary cancer center

Cited by 19 publications

References 35 publications

An Update on the Epidemiology, Molecular Characterization, Diagnosis, and Screening Strategies for Early-Onset Colorectal Cancer

An Update on the Epidemiology, Molecular Characterization, Diagnosis, and Screening Strategies for Early-Onset Colorectal Cancer

Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors

The Budget Impact of Monoclonal Antibodies Used to Treat Metastatic Colorectal Cancer in Minas Gerais, Brazil

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